Carboxyhemoglobin levels in patients with cocaine-related chest pain.
Kales-SN; Feldman-J; Pepper-L; Fish-SS; Ozonoff-D; Christiani-DC
Chest 1994 Jul; 106(1):147-150
Carboxyhemoglobin (COHb) levels were measured in emergency room patients presenting with acute chest pain, focusing on patients with cocaine (50362) related chest pain and various comparison groups with ultimate diagnoses of nonischemic chest pain. The cocaine group was younger and had more cigarette smokers. Emergency department mode of arrival and disposition were similar for both groups. The nonischemic group included 16 persons with noncardiac diagnoses and 17 with nonischemic, cardiac problems. For all subjects, the mean COHb levels were higher among smokers than nonsmokers. For the cocaine group as a whole, the mean COHb was significantly higher than that of the nonischemic group. Considering only tobacco smoking patients, the cocaine group still had higher COHb levels. The majority, nine of the 13, reported smoking crack as one of their routes of abuse. No deaths occurred, but two of the 13 cocaine abusers suffered myocardial infarctions. The data indicated that acute elevations in COHb due to cocaine smoking or baseline elevations due to smoking tobacco or other substances, or both, may be important in cases of cocaine related myocardial ischemia. The authors suggest that elevations in COHb levels would further increase tissue hypoxia in the pulmonary bed as well.
NIOSH-Publication; NIOSH-Grant; Training; Substance-abuse; Blood-analysis; Humans; Cardiovascular-system-disorders; Cardiovascular-function; Cigarette-smoking;
Harvard University, Boston, Massachusetts